Come Together

Health-care summit

Newt Gingrich, the former Speaker of the House, is a reader—and something of a postmodern interpreter—of the works of Albert Camus and George Orwell. A few days before President Obama’s big health-care “summit,” Gingrich addressed the Conservative Political Action Conference. He cited Camus’s “The Plague,” summarizing its message with Jack Nicholsonian authoritativeness: “The authorities can’t stand the truth.” His discussion of Orwell was more narrowly targeted. The message of “1984,” he explained, is

that centralized planning inherently leads to dictatorship, which is why having a secular socialist machine try to impose government-run health care in this country is such a significant step away from freedom and away from liberty, and towards a government-dominated society.

Orwell’s position on the House and Senate health-care bills is unknown, but, like Camus, he was a lifelong democratic socialist (he was a member of the Independent Labour Party, which regarded regular Labourites as wishy-washy) and, as such, a big fan of government-run health care. Confusion about who is and who is not a socialist and what is and what is not socialism was endemic at C-PAC, as the conference’s participants affectionately call it. “The hope and change the Democrats had in mind was nothing more than a retread of the failed and discredited socialist policies that have been the enemy of freedom for centuries all over the world,” Senator Jim DeMint, of South Carolina, said, adding, in a reference to the President, “Just because you are good on TV doesn’t mean you can sell socialism to freedom-loving Americans.” Representative Steve King, of Iowa, listed the enemy within: “They are liberals, they are progressives, they are Che Guevarians, they are Castroites, they are socialists.” Then he mentioned a few more key segments of the Democratic coalition, including, besides Trotskyites, Maoists, Stalinists, and Leninists, “Gramsci-ites—ring anybody’s bell?” Strictly speaking, that should be Gramscians, followers of Antonio Gramsci, the Italian Communist Party leader of the nineteen-twenties. Ding-dong!

To be fair, C-PAC is a gathering of the tribe—“our Woodstock,” one speaker called it—so a certain amount of nude dancing in the rhetorical mud is mandatory. Outside the conservative confab’s comfy confines, the Party’s pols were more restrained during the days leading up to the marathon conversation that Obama convened last Thursday. But they made it fairly clear that they were in no mood to be “bipartisan” or in any way make themselves complicit in something that could be construed as an accomplishment (let alone a victory) for Obama and the Democrats. “You know,” John Boehner, the House Republican leader, said on Wednesday, “we’ve asked the President all year to scrap this big government-takeover bill and let’s start with a clean sheet of paper.” On Thursday, any lingering doubts were removed. By way of describing their demand, Republican speakers used the words “scrap,” “start over,” and “clean sheet of paper” twenty times. In other words: unconditional surrender.

The summit consisted of seven and a half hours of jabber divided among thirty-eight members of Congress and three Administration officials, every one of whom had to have at least one turn. Therefore, as anyone who watched it all (or as much of it as attending to bodily needs and psychic balance allowed) can attest, it was stupefying—as stupefying, perhaps, as the twenty-seven-hundred-page health-care bill itself, a foot-high copy of which the Republicans brought along as a prop. Yet, like that bill, its individual components were frequently worth the trouble. The discussion produced no compromises—it was a debate, not a negotiation—but it was clarifying.

The Democrats made it clear that they intend to cover the uninsured before another lifetime or two elapses; the Republicans made it equally clear that they do not. “We just can’t afford this,” Eric Cantor, the House Republican whip, said, adding dismissively, “In a perfect world, everyone would have everything they want.” But, even when the two sides seemed to agree on a particular goal, the similarities were irreconcilable, so to speak. For example, both sides say that they favor making it impossible for people with “preëexisting conditions” to be refused insurance. Obviously, this can’t be done by simply ordering insurance companies to accept such people. Too many of the young and healthy, knowing that they couldn’t be refused, would wait to buy insurance until they got sick; the ranks of the insured would grow thinner and sicker, and premiums would balloon. Without the universal or near-universal coverage that Democrats support, just telling insurance companies that they must accept everyone becomes another way of distributing health care by ability to pay. We have enough of that already. Segregating the sick into “high-risk pools”—the oxymoronic Republican solution—has generally flopped in states where it has been tried. A similar logic holds for allowing the purchase of insurance across state lines, another point of nominal bipartisan agreement. Without the sort of standards that Democrats want and Republicans don’t, those among the young, the healthy, and the poor who bought insurance at all would choose the cheapest, skimpiest policies from companies in the least regulated states, leaving people who need the kind of insurance many of us are lucky enough to have in shrinking pools with increasingly unaffordable premiums—the “race to the bottom” that the Democrats kept talking about.

In his opening remarks at the summit, Senator Lamar Alexander, of Tennessee, borrowing a favorite gibe from Mitch McConnell, the Senate Minority Leader, said that if the Democrats decline to abandon their attempt at comprehensive reform “the only thing bipartisan will be the opposition to the bill.” In one sense, Alexander was right: all the supporters of health-care reform in Congress are Democrats, while the opposition consists of both Republicans and Democrats. The Republicans have become—monolithically, on this is-sue and many others—the party of the right. The Democrats are the party of the center-left. The congressional center, in other words, consists entirely of Democrats, many of whom hold seats that once belonged to liberal Republicans, a breed that conservatives of both parties have hunted to extinction. But in another sense Alexander was wrong: the Democrats’ bill more closely resembles Richard Nixon’s health-care proposal—the one that Ted Kennedy went to his grave regretting he hadn’t embraced—than it does Bill Clinton’s, to say nothing of Harry Truman’s. Nor are all its Republican features archeological. “Our bill contains over a hundred and forty-seven distinct Republican amendments,” Senator Tom Harkin, of Iowa, reminded his summit colleagues. The health-care reform bill—which, despite everything, is still alive—is an ambitious piece of legislation, however modest it may be by the measure of the rest of the developed world. Ideologically and substantively, it is centrist. It has Republicans, and Republicanism, in its family tree. For better or for worse, it’s already bipartisan. Gramsci would not be pleased. ♦

Hendrik Hertzberg is a senior editor and staff writer at The New Yorker. He regularly blogs about politics.